Cardiovascular drugs impact many pathways involved in depression pathophysiology and treatment. However, their distinct impact on mood is underrecognized and the literature is conflicting. Therefore, using a very large and well-characterised sample of older adults with hypertension, we aimed to investigate the prevalence of depressive symptoms in users of different antihypertensive classes. We analysed baseline data from 14,195 older individuals with hypertension enroled in a large clinical trial. Median age was 75 years. The association of antihypertensive use by class and depression prevalence, as measured by a validated depression scale, was determined using logistic regression models. Multivariable logistic models were implemented to account for important confounding factors. Our analyses showed a positive association between depressive symptoms and the use of beta blockers (BB) (OR: 1.37; 95% CI: 1.17-1.60, p < 0.01), compared with users of other antihypertensive classes. All other classes of antihypertensives (including angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and calcium channel blockers) were not significantly associated with depressive symptoms. In secondary analysis, this relationship was stronger for lipophilic (39%) and nonselective BB (52%) compared with hydrophilic (26%) and selective medications (31%), respectively. This study adds further evidence for a probable association between BB and depression in a large sample of older adults with hypertension and no history of cardiovascular disease or heart failure. These findings should regenerate interest and increase awareness of clinicians about the possible adverse effects of these medications in an otherwise healthy older population.

中文翻译：

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居住在澳大利亚和美国的大量老年人群中抗高血压药物使用和抑郁症状的关联：一项横断面研究。

心血管药物影响涉及抑郁症病理生理学和治疗的许多途径。然而，它们对情绪的明显影响未被充分认识，并且文献是相互矛盾的。因此，我们使用一个非常大且特征明确的高血压老年人样本，旨在调查不同抗高血压药物使用者中抑郁症状的患病率。我们分析了参加大型临床试验的 14,195 名老年高血压患者的基线数据。中位年龄为 75 岁。使用逻辑回归模型确定不同类别的降压药使用与抑郁症患病率之间的关联，由经过验证的抑郁量表衡量。实施多变量逻辑模型以解释重要的混杂因素。我们的分析显示，与使用其他抗高血压药物的使用者相比，抑郁症状与使用 β 受体阻滞剂 (BB) 之间呈正相关（OR：1.37；95% CI：1.17-1.60，p < 0.01）。所有其他类别的抗高血压药（包括血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂和钙通道阻滞剂）与抑郁症状没有显着相关性。在二级分析中，与亲水性 (26%) 和选择性药物 (31%) 相比，亲脂性 (39%) 和非选择性 BB (52%) 的这种关系更强。这项研究进一步证明，在没有心血管疾病或心力衰竭病史的老年高血压患者的大量样本中，BB 与抑郁症之间可能存在关联。